In the U.S., approximately 40% of the population has some hyperglycemic condition. Worksite interventions offer a promising framework for delivering public health interventions to people with prediabetes, since worksites reach a large segment of the population for most of their adult life. The opportunity for long-term follow-up and support may be greater through worksites than through clinic- or community-based programs. Both the employee and employer have a vested interest in maintaining the health of the workforce and controlling health care costs. Therefore, the purpose of this study is to evaluate the impact of a worksite intervention compared to usual care among adults aged 18-65 years with prediabetes (n=76) at The Ohio State University (OSU). OSU is the second largest public university in the U.S. and includes a premier medical center. Participants will be randomly assigned to either a 16-week, group-based, lifestyle intervention delivered at the worksite or to usual care. The 16-week group- based intervention, adapted from the Diabetes Prevention Program, emphasizes reduction in dietary fat and energy intake and at least 150 minutes/week of moderate physical activity. The impact of the intervention on percent change in weight (primary outcome), fasting glucose, lipid panel, blood pressure, weight parameters, dietary intake (via food frequency questionnaire assessment), physical activity, quality of life, and constructs related to problem solving and goal setting theories will be determined and compared to usual care post-intervention and at 3-month follow-up. The findings from this study will enable the investigators to refine recruitment strategies and intervention procedures to develop a potentially sustainable university-based program for employees with prediabetes for a larger translational clinical trial. PUBLIC HEALTH RELEVANCE: Worksite interventions offer a promising framework for delivering greater care to people with prediabetes, since worksites reach a large segment of the adult population. The effect of a structured lifestyle intervention designed to promote weight loss and prevent type 2 diabetes compared to usual care will be determined. The findings will be used to deliver an effective intervention to employees that can be sustained through university worksite settings.